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How ready are Appleton's hospitals for a surge of coronavirus patients? Here's a look at their plans

Faculty members work on a "surge" plan to deal with a possible influx of coronavirus patients at ThedaCare's hospital in New London Wednesday.(Photo: Dan Powers/USA TODAY NETWORK-Wisconsin)

As the coronavirus has swiftly coursed through Wisconsin, sending the state's confirmed case count from just one at the beginning of March to over 700 near the end of the month, hospitals and clinics are racing to expand their capacity for treatment and make game plans for scenarios they hope never come to pass.

Those numbers would surely be cause for alarm for the hospitals. A spokesperson from the Wisconsin Hospital Association said the state's health care system has 11,000 beds, and 2,600 ICU beds, which they'd need to stretch should a surge of patients need hospitalization.

Appleton's two major health systems say they've got the flexibility to pull that off.

Outagamie, Calumet and Winnebago counties have as of yet managed to avoid the soaring case numbers that the state's largest cities have reported, recording just four, one and six positive tests, respectively.

But those numbers will certainly grow as testing capacity expands and the virus spreads throughout the community, meaning both ThedaCare's Appleton hospital and Ascension's St. Elizabeth hospital are readying for the next phase of the pandemic.

How many beds could be needed?

The answer, of course, depends on how bad the outbreak gets. A recent analysis by the Harvard Global Health Institute played out nine different scenarios, simulating what would happen if 20%, 40% or 60% of Americans got sick over six, 12 or 18 months.

In the Appleton referral region, a "moderate" outbreak where 40% of residents get COVID-19 over the course of a year, there would be 3.2 times the number of patients as available beds at a given time.

According to the hospitals provider directory from the state Department of Health Services, St. Elizabeth has 332 licensed beds and ThedaCare's Regional Medical Center-Appleton has 160.

However, licensed beds represent how many beds a hospital could have, not the amount they currently do have. A 2018 Wisconsin Hospital Association report showed St. Elizabeth had 190 beds set up and staffed, with just over a 50% occupancy rate, and ThedaCare's hospital had 156 beds set up and staffed, with about a 55% occupancy rate.

What do Appleton's hospitals say about beds?

Both health systems declined requests to confirm the number of beds available in Appleton. Most other hospitals in the state have responded similarly, saying that number changes constantly.

At ThedaCare, chief medical officer Jennifer Frank said the plan is to have a solid day-to-day assessment of their situation: Are patients being cared for in the right locations? How full are the beds? Should an entire unit of the hospital be converted to only care for coronavirus patients?

They'll also try to make space in other ways — Mark Cockley, chief clinical officer and president of ThedaCare's Clinically Integrated Network, said there are "multiple efforts underway including staging and repurposing rooms to provide virus-related treatment and setting up temporary structures at our hospitals that will allow flexibility with added shelter space."

The health system also announced that it would postpone all elective, non-urgent care at its seven hospitals on March 19, freeing up space for possible COVID-19 patients.

Ascension also moved to postpone non-urgent procedures and medical visits to deal with a possible surge.

What about their other supplies?

Both health systems declined to share specific numbers of N95 masks, surgical masks and ventilators currently on-hand. But we know the supply is limited statewide and across the nation, which could pose big risks if the number of very ill patients swells.

Gov. Tony Evers has requested 54,709 N95 respirators, 130,326 surgical masks, 24,816 face shields, 20,233 surgical gowns, 104 coveralls and 72,044 gloves from the Strategic National Stockpile, the amount the state is eligible for. But state officials warned last week that even that number may not be enough.

The state has 620 ventilators — crucial to the treatment of the worst cases — and will request more from the federal stockpile.

At the time she was interviewed two weeks earlier, Frank said ThedaCare was well stocked and was not experiencing supply shortages. But they're prepared to get creative — for example, evaluating whether it's possible that clean linen gowns could replace paper ones.

An Ascension Wisconsin spokesperson said the health system is arranging expedited supply shipments, assessing alternative products and making use of intra-hospital transfers, as well as conserving some supplies in anticipation of a future shortage.

What if the staff gets sick?

At the end of the day, beds and masks and ventilators are only of use if there's a staff member there to administer care, which is why states have rushed to protect health care workers during the pandemic. In Wisconsin, those workers get priority in testing at the state lab.

Though ThedaCare has not had widespread illness among staff in the past and thus has only practiced "flexing" its numbers on a smaller scale, Frank said it still has the tools to do it successfully.

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A large tent is erected in front of the Level II Trauma Center at ThedaCare Regional Medical Center on March 18 in Neenah.(Photo: Dan Powers/USA TODAY NETWORK-Wisconsin)

Some of those staffing strategies include bringing people in administrative roles back to their previous clinician role, allowing clinicians who are self-quarantined but healthy to conduct video visits with patients, or even designating other "well clinics" to serve patients who do not have coronavirus and provide a safe, separate workplace for staff who might be more vulnerable to the virus.

Ascension Wisconsin did not directly respond to how it would stretch its staff should a significant number of employees become ill, but a spokesperson did cite the cancellation of non-urgent procedures as a way to handle "associate redeployment."

Working together, preparing separately

Frank said since the virus began to tear through the U.S., she and her team have been watching how hospitals respond — paying close attention to Washington and California, which were hit hard first.

In the event that a large swath of the region is sickened, she said, every available health system would work together to bring the virus under control.

Both Appleton hospitals belong to the Fox Valley Healthcare Emergency Readiness Coalition, which facilitates coordination among hospitals and local and state agencies to prepare for times like this. That coalition doesn't include Green Bay's Bellin Health, which is part of a different coalition, but Frank said the two health systems still communicate about how to handle care throughout the valley.

But though hospitals will work together, it's important to be prepared on their own, she added.

"If ThedaCare Appleton is hit hard, it's very likely St. E's will be hit hard too," Frank said. "We intend to be cooperative, but our planning does not rely on them to have capacity we don't."

Contact Madeline Heim at 920-996-7266 or mheim@gannett.com. Follow her on Twitter at @madeline_heim.